Judge questions health risks of Stokes' practices

GRAND RAPIDS -- Even while sentencing Dr. Robert Stokes to 10 1/2 years in prison for widespread medical fraud, a federal judge raised questions about the seriousness of the health risk allegedly facing thousands of the dermatologists' former patients.

Press Photo/Delbridge Langdon Jr.Dr. Robert Stokes leaves federal court after he was sentenced to 10.5 years in prison. He was released on bond until he is ordered to appear in federal prison.

Federal sentencing guidelines call for a prison term of 12 1/2 to 15 1/2 years, and prosecutors had pushed for an even longer sentence.

U.S. District Judge Gordon Quist said Thursday that, while the Grand Rapids doctor abused his authority and targeted vulnerable patients, he did not consciously or recklessly risk their health with recycled sutures and unsanitary equipment -- allegations prosecutors hoped would lengthen Stokes' sentence.

"There was a lot of fright in the community," Quist said during a nine-hour sentencing hearing that included testimony from medical experts, former patients, former employees and statisticians.

Quist found no "preponderance" of evidence Stokes reused syringes. Even though he reused sutures, Quist said, they were cleaned with chemicals that destroyed blood-borne diseases.

The judge allowed Stokes to leave court on bond and report later to federal prison. Quist also ordered him to spend 3 1/2 years on supervised release and pay $175,000 in fines. The judge expects to order restitution later.

Stokes was sentenced the same day the Kent County Health Department announced it would send letters to about 8,500 of Stokes' former patients -- in addition to 5,000 already notified -- suggesting they consider tests to determine whether they contracted blood-borne diseases such as HIV, hepatitis B and hepatitis C.

Assistant U.S. Attorney Raymond Beckering said he still believes Stokes' practices posed a risk. Health officials stood by their call for a longer sentence, although they said the risk is slight.

Kent County corporate counsel Sherry Batzer said she is aware of one patient who has been diagnosed with hepatitis C, but there is no way to determine if it was caused by Stokes.

"We believe there was a risk of harm ... an unnecessary, unjustified risk," Beckering said.

Stokes, 56, of East Grand Rapids, was convicted in April on 31 counts of fraud for overcharging insurance companies for procedures he did not perform. The doctor frequently removed growths -- sometimes freckles or blemishes -- after scaring patients into believing they were pre-cancerous. He also double-billed for visits by falsely claiming patients had impetigo, a highly contagious bacterial infection.

The judge found the fraud totaled more than $1 million.

Feds call fraud long-term
Prosecutors on Thursday painted Stokes as a doctor driven by greed, so arrogant that he continued to rip off insurance companies and hundreds of patients even after audits and warnings in the 1990s, after agents raided his office in 2001, and after he was criminally charged in August 2006.

Witnesses on Thursday testified Stokes used braided, absorbable sutures, pulling them all the way through a patient's wound. He then reused leftovers on another patient -- a "Third World" practice that could lead to infection, an expert said.

However, experts acknowledged that while re-using sutures violates medical standards, his practice of cleaning the leftovers with chemicals was enough to kill infectious diseases. The judge agreed.

"I became a doctor to help people," he told the judge before sentencing. "I never intended to harm my patients. I don't think I've done so. There's much more to my life than the actions that led to my conviction."

"My reputation is now in ruins. My only hope is that the sentence you impose gives me the opportunity to rebuild my life."

Stokes' attorneys repeatedly tried to remove the human element from the case. The biggest victims were insurance companies, not patients, they said.

"It was really no more than a run-of-the-mill fraud case ..." said his attorney, Mark Kriger.

Prosecutors, however, said Stokes' victims numbered in the hundreds, including patients who paid more than $500 in co-pays or deductibles. The fraud, Beckering said, was pervasive and went on for years.

Just before Stokes' trial in April, prosecutors learned about the potential health risk from two of the doctor's employees, Beckering said. They immediately notified the Kent County Health Department, which did not issue a health alert until November, he said.

Bill Anstey, the county's deputy administrative health officer, said the county didn't immediately disclose the threat because Stokes' employees initially refused to sign their names to statements.

"How do you know it's not just someone who is disgruntled with Dr. Stokes?" Anstey said. "We wanted to be certain that what was said was true before we issued any warnings that could potentially scare people."

Jaime Droog, a former employee who testified against Stokes, said prosecutors told her the Health Department simply did not have enough evidence in April to issue a health alert.

Droog said she cooperated with prosecutors and health officials, but said other employees did not. "A couple of people (with knowledge) were longtime employees. They were very loyal to Stokes," she said. "I did everything I could, short of bending over backward."

Former patient Melissa Poliuto, who testified that Stokes fraudulently overcharged for a procedure he performed the day after he was indicted, said she was satisfied with his prison sentence.

"That's a long time, long enough," Poliuto said.

-- Press staff writers John Tunison and Nate Reens contributed to this story.